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Cardiorespiratory fitness as a quantitative predictor of the risk of stroke: a dose–response meta-analysis

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Abstract

Background and purpose

Cardiorespiratory fitness (CRF) is closely related to our health, but whether high cardiorespiratory fitness could reduce stroke risk remains controversial. We used a meta-analysis to examine the overall association between cardiorespiratory fitness and stroke incidence.

Methods

A systematic search was performed in PubMed, EMBASE, and Web of science. We estimated the overall relative risk (RR) of stroke incidence for high levels of CRF individuals versus individuals with low levels of CRF. Meanwhile, we made a quantitative analysis of the association between CRF and the risk of stroke.

Results

14 cohort studies containing 1,409,340 participants were included in this meta-analysis, and 23,894 stroke patients were observed. The meta-analysis documented that the high-CRF individuals had a 42% lower risk of stroke (RR_0.58; 95% CI 0.51–0.66) compared with low-CRF individuals. Besides, subgroup analysis showed that the inverse association of CRF with the risk of stroke was consistent. There are 29% lower risk of ischemic stroke (RR_0.71; 95% CI 0.54–0.93) and 31% lower risk of hemorrhagic stroke (RR_0.69; 95% CI 0.47–1.00). Dose–response analysis showed that every “unit-dose” increment of five metabolic equivalents (METs) reduced a 15% lower risk of stroke (RR_0.85; 95% CI 0.79–0.91).

Conclusion

This meta-analysis provides the evidence that better CRF was with a lower risk of stroke incidence.

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Funding

This work was supported by a grant from National Scientific Foundation of China NSFC81771961.

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Author notes

  1. Yangyang Wang and Feng Li contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Neurosurgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, China

    Yangyang Wang, Feng Li, Yuan Cheng, Lingui Gu & Zongyi Xie

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  1. Yangyang Wang
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  2. Feng Li
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Contributions

YYW: conceptualized the study; ZYX, YYW and FL: design of study; YYW, FL and LGG: literature retrieval, study selection, data extraction, statistical analyses, interpretation of the data and drafting of the initial manuscript; YC: quality evaluation; ZYX: critical revision and comment for important intellectual content; all authors reviewed and approved the final manuscript.

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Correspondence to Zongyi Xie.

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This article does not contain any studies with human participants performed by any of the authors. As a systematic review and meta-analysis, no ethical approval or consent to participate was required.

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Wang, Y., Li, F., Cheng, Y. et al. Cardiorespiratory fitness as a quantitative predictor of the risk of stroke: a dose–response meta-analysis. J Neurol 267, 491–501 (2020). https://doi.org/10.1007/s00415-019-09612-6

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